Now, anyone who needs to undergo surgery at a private hospital can compare what their doctors are charging them against a fee benchmark recently published by the Ministry of Health (MOH).

This initiative by the MOH, to introduce private surgeon fee benchmarks for 222 common surgical procedures, comes on the back of soaring medical inflation and private healthcare insurance premiums.

According to MOH, healthcare inflation was 2.6% per annum in the period of 2007 to 2017. During the same period, the average inpatient hospital bill rose by significantly more – 4.9% for Class A public hospitals and almost twice as much, at 9.0%, for private hospitals.

Here are four things you need to know about the fee benchmarks so you can utilise them effectively.

# 1 What Exactly Is The Private Surgeon Fee Benchmark?

The private surgeon fee benchmarks is what MOH recommends we should be paying for surgeon fees in private sector hospitals. It is not meant for patients going to public hospitals as doctors are salaried rather than paid based on surgical procedures.

The fee benchmark is meant for consumers and patients to use a point of reference rather than a cap for what surgeons can charge.

As mentioned, MOH likely introduced surgeon fee benchmarks to curb unsustainable inflation in such fees in the private sector. While there are other components to our hospitalisation bills, such as facility fees or anaesthetist fees, surgeon fees make up a sizeable single component of it.

The surgeon fee benchmark was created after MOH consulted extensively with key stakeholders, including over 120 specialist doctors from the private sector as well as leaders from the Singapore Medical Council, all major health insurance providers and third-party administrators, public and private hospital administrators and patient advocates such as CASE and NTUC.

# 2 How To Use The Surgeon Fee Benchmark?

Today, MOH already publishes historical data on public and private treatment fees to give patients an estimate of how much they may have to pay at the low (25th percentile) middle (50th percentile) and high (75th percentile) levels. With the private surgeon fee benchmark, they are going one step further to recommend a level of fees that is reasonable.

We can also refer to MOH’s “patient journey”. When we need to undergo surgery, our surgeon will tell us the necessary treatments and the outcome we can expect. Using the new surgeon fee benchmark, our doctor will also advise us on the estimated total bill for the surgery, and the surgeon fee component. He will then explain how the surgeon fees rank compared to the fee benchmark, and, if our estimated bill is higher, inform us how our case is more complex in nature. If we are still unsure, we can go back to our referring family doctor or seek a second opinion.

Source: Ministry of Health (MOH)

During a briefing by MOH that we attended, a spokesperson said that doctors can charge more than the fee benchmarks if a case is more complicated than usual. So, if our doctor informs us that our case is standard, we can expect to pay within the recommended range, and can query our doctor if the charges turn out to be higher than what the fee benchmark recommends.

# 3 What To Do If My Surgeon Fees Are Higher Than The Benchmark Fees?

While it can be very tricky for patients to question their doctors’ fees in private hospitals, patients have to be aware of the recommended charges. This is why MOH is working with doctors to include the comparison of surgeon fees with the benchmark fees when they are consulting with their patients.

As mentioned above, if our doctor informs us that we are undergoing a straightforward procedure, the bill should rightly be within MOH’s recommended fee benchmark. If it is higher, we can ask our doctor to provide some insights into the complexity of our case to understand both why we are being charged higher and to get more insights into our health situation.

This is also where health insurers get involved to query doctors on the fees that are charged. This is already going on today, and the fee benchmarks will provide a gauge of recommended surgeon fees for the insurers as well. Insurers can also use this fee benchmark to design their healthcare policies going forward.

# 4 What If There Are No Fee Benchmarks For My Surgery?

The 222 surgical procedures that have a fee benchmark account for close to 85% of all surgical procedures undertaken in Singapore. This means there will be 15% of cases that do not have a fee benchmark for them. So, we should not be alarmed if our doctor does not bring up a fee benchmark (of course, we should still do our own research afterwards).

When this happens, we can ask our doctors two things – 1) what is a comparable surgery that is listed on the fee benchmark (in terms of complexity and if any) and 2) how complex is our individual case. This can give us a gauge on what kind of surgeon fees to expect.

If we are still unsure, we can also go back to our referring family doctor or seek an second opinion as well.

A More Sustainable Increase In Healthcare Costs In The Future

The introduction of the surgeon fee benchmark is not going to suddenly stop the increase in healthcare costs. As Singapore greys, and technology enables even more advanced medical solutions, healthcare costs is going to continue rising.

The hope is that the fee benchmark will lend a helping hand in keeping healthcare costs affordable for all. What the surgeon fee benchmark does is provide price transparency in the private medical industry and allow patients to make more informed decisions.

Apart from patients, the fee benchmark will also influence reasonable fees being charged. Firstly, private healthcare providers and surgeons now know that patients are better informed and they also know that health insurance providers will be more likely to seek explanations when fees surpass the benchmarks.

Lastly, the fee benchmarks are only part of the overall plan to keep healthcare costs in check. The government is actively playing a part in getting people in Singapore to live healthier lifestyles, it is also working with health insurers to introduce mandatory co-payment riders (and remove full riders) to ensure patients are more cost and treatment conscious, and publishing complementary guides, including Appropriate Care Guides and Drug Guidances. Many insurers themselves already have preferred doctor and specialist panels they trust to charge reasonable rates as well as actively query patient bills currently.

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